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As part of the Massachusetts Hospital Association (MHA)’s ongoing efforts to educate hospital chief executive officers about the Communication, Apology, and Resolution (CARe) approach to address adverse medical events, MHA held a high-level overview of the CARe process for its Board of Trustees during their January board meeting. It has been learned that patients confronted with an “unanticipated adverse outcome” don’t necessarily want a payout. They want to know what happened, receive some sort of recognition from providers that they were harmed, and they want to ensure that what happened to them does not happen to another patient.

Evan M. Benjamin, MD, from Tufts University School of Medicine and Baystate Health, and Kenneth F. Sands, MD, MPH, from Beth Israel Deaconess Medical Center and Harvard Medical School, made the presentation to the MHA board members, outlining how CARe works: Clinicians and hospital leadership communicate with patients and families when unanticipated adverse outcomes occur; investigate and explain what happened; and implement systems to avoid recurrences and improve patient safety. In addition, where appropriate, patients receive an apology and offer of fair financial compensation without the patient having to file a lawsuit. Each case is run through an algorithm to determine the best course of action to take.

MACRMI is the Massachusetts Alliance for Communication and Resolution following Medical Injury – the umbrella group of providers, insurers, associations (including MHA), hospitals, and attorneys that are committed to rolling out the CARe model. The presentation at MHA not only provided information about CARe, it encouraged hospital leadership buy-in to join a growing number of pilot sites for the program. The six original pilot sites for the program are Beth Israel Deaconess Medical Center; Beth Israel Deaconess Hospital-Needham; Beth Israel Deaconess Hospital-Milton; Baystate Medical Center; Baystate Franklin Medical Center; and Baystate Mary Lane Hospital. These pilot sites have most recently been joined by two more Massachusetts care providers, Sturdy Memorial and Atrius Health.

Following the CARe presentation, MHA Board members said the approach clearly has a beneficial component not only for patients, but also for the caregivers involved in an unanticipated event. And there can be a beneficial financial component to the MACRMI/CARe process, as it often eliminates lawsuits.

I encourage you to review this MACRMI Resource: Implementation Guide, which outlines the steps your organization can take to create a CARe program, and provides contact information.  In addition, The Third Annual Communication, Apology, and Resolution Forum hosted by MACRMI will take place on Thursday, May 19, 2015. Stay tuned at this website for more information.


Pat Noga, PhD, RN

MACRMI Leadership

VP, Clinical Affairs


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